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Friday, 14 October 2016 14:39

Virginia

Social Work:

The Virginia Social Work Board requires a clinician to be a licensed social worker in the state if the client is located in Virginia.
The board issued "Guidance on Technology-Assisted Therapy and the Use of Social Media": http://www.dhp.virginia.gov/social/guidelines/140-3.pdf

Psychology:

We are not aware of any specific rules and regulations of the practice of telemental health services by Psychologists in Virginia.

Counseling, Marriage and Family Therapists and Licensed Substance Abuse Treatment Practitioners

Counselors

Virginia Board of Counseling

Guidance on Technology-Assisted Counseling and Technology-Assisted Supervision, 2015

https://www.dhp.virginia.gov/counseling/guidelines/115-1.4%20Technology-Assisted.doc

Guidance on Technology-Assisted Counseling and Technology-Assisted Supervision

 

The Board’s regulations for Standards of Practice (18VAC115-20-130) are prefaced by the following:

The protection of the public health, safety, and welfare and the best interest of the public shall be the primary guide in determining the appropriate professional conduct of all persons whose activities are regulated by the board. Regardless of the delivery method, whether in person, by phone or electronically, these standards shall apply to the practice of counseling.

Therefore, the standards of practice set forth in section 130 of the regulations and in the Code of Virginia apply regardless of the method of delivery.  The Board of Counseling recommends the following when a licensee uses technology-assisted counseling as the delivery method:

 

1. Counseling is most commonly offered in a face-to-face relationship. Counseling that from the outset is delivered in a technology-assisted manner may be problematic in that the counseling relationship, client identity and other issues may be compromised.

 

2. The counselor must take steps to protect client confidentiality and security.

 

3. The counselor should seek training or otherwise demonstrate expertise in the use of technology-assisted devices, especially in the matter of protecting confidentiality and security.

 

4. When working with a client who is not in Virginia, counselors are advised to check the regulations of the state board in which the client is located. It is important to be mindful that certain states prohibit counseling by an individual who is unlicensed by that state.

 

5. Counselors must follow the same code of ethics for technology-assisted counseling as they do in a traditional counseling setting.

 

Guidance for Technology-assisted Supervision

 

The Board of Counseling recommends the following when a licensee uses technology-assisted supervision:

 

1. Supervision is most commonly offered in a face-to-face relationship. Supervision that from the outset is delivered in a technology-assisted manner may be problematic in that the supervisory relationship, client identity and other issues may be compromised.

 

2.  The counselor must take steps to protect supervisee confidentiality and security.

 

3. The counselor should seek training or otherwise demonstrate expertise in the use of technology-assisted devices, especially in the matter of protecting supervisee confidentiality and security.

 

4. Counselors must follow the same code of ethics for technology assisted supervision as they do in a traditional counseling/supervision setting.

 

5. The Board of Counseling governs the practice of counseling in Virginia.  Counselors who are working with a client who is not in Virginia are advised to check the regulations of the state board in which a supervisee is located. It is important to be mindful that certain states may regulate or prohibit supervision by an individual who is unlicensed by that state. 

Sunday, 09 October 2016 16:49

New Hampshire

The New Hampshire Board of Mental Health Practice notes the following:

If you are located in New Hampshire and are providing mental health services to a consumer located in another jurisdiction, you are considered to be practicing in New Hampshire and need to be licensed in this State. If you are located in another state and are providing mental health services to a consumer located in New Hampshire, you are considered to be practicing in New Hampshire and need to be licensed in this State.

www.oplc.nh.gov/mental-health/index.htm

Sunday, 09 October 2016 16:48

Nevada

Social workers

Bd. of Exam’rs for Social Workers’ regulations.

CHAPTER 641B - SOCIAL WORKERS

GENERAL PROVISIONS

https://www.leg.state.nv.us/NAC/NAC-641B.html

   NAC 641B.124  Practice by electronic, telephonic or other means. (NRS 641B.160)  The provision of social work services to a client within this State through any means, including, without limitation, electronic means or by telephone, regardless of the location of the social worker, constitutes the practice of social work and is subject to the provisions of chapter 641B of NRS and any regulations adopted pursuant to that chapter.

     (Added to NAC by Bd. of Exam’rs for Social Workers by R113-98, eff. 1-13-99)

Sunday, 09 October 2016 16:47

Nebraska

We are not aware of any specific rules and regulations of the practice of telemental health services, but the state Telehealth Act is provided in the following link:

http://dhhs.ne.gov/publichealth/Licensure/Documents/NebraskaTelehealthAct.pdf

Sunday, 09 October 2016 16:47

Montana

Psychologists

Board of Psychologists

Definition of professional relationship.

http://www.mtrules.org/gateway/RuleNo.asp?RN=24%2E189%2E301

Rule: 24.189.301    DEFINITIONS

(1) "Defined professional relationship" means a relationship in which a licensee or license applicant provides diagnostic, assessment and/or therapeutic services to a client. A defined professional relationship shall be initially established in a context where services are provided:

(a) in person and face-to-face; or

(b) transmitted via electronic or related methods. If provided under this subsection, the context must also be:

(i) two-way;

(ii) interactive;

(iii) real-time;

(iv) simultaneous;

(v) continuous; and

(vi) providing for both audio and visual interaction.

Sunday, 09 October 2016 16:46

Missouri

We are not aware of any specific rules and regulations of the practice of telemental health services.
Sunday, 09 October 2016 16:45

Mississippi

Counselors:

https://www.lpc.ms.gov/secure/pdf/Part%202201%20Rules%20and%20Regulations%20Revised%2002.14.2018.pdf

Mississippi Reg Page 42

Rules and Regulations Mississippi State Board of Examiners for Licensed Professional Counselors

Rule 7.5: Practice of Distance Professional Services Any person that provides counseling or supervision services through the means of Distance Professional Services must hold a license in good standing in both the location where services are provided by the professional as well as in the location of the recipient of the services and must also hold the Distance Credentialed Counselor credential or its equivalent as recognized by the Center for Credentialing and Education, Inc. (CCE) or the National Board of Certified Counselors. Distance Professional Services must be performed in accordance with these Rules and Regulations, the current American Counseling Association’s Code of Ethics, the current National Board for Certified Counselors Policy Regarding the Provision of Distance Profession Services, and Mississippi and Federal law.

Sunday, 09 October 2016 16:45

Minnesota

We are not aware of any specific rules and regulations of the practice of telemental health services.
Sunday, 09 October 2016 16:44

Michigan

We are not aware of any specific rules and regulations of the practice of telemental health services.
Sunday, 09 October 2016 16:44

Massachusetts

Psychologists

Massachusetts Board of Registration in Psychology’s current thinking with regard to provision of services via electronic means.

Consumer Affairs and Business Regulation

http://www.mass.gov/ocabr/licensee/dpl-boards/py/regulations/board-policies/provision-of-services-via-electronic-means.html

Provision of Services Via Electronic Means

Originally adopted in March 2005

Updated October 2015

In response to inquiries from licensees and other interested parties, the Board would like to share its current thinking with regard to provision of services via electronic means. The Board recognizes that this is an evolving practice issue, and its policy may be updated from time to time.  However, there are some issues and policies that the Board believes are important to share, even as this area evolves.  The Board believes that psychologists should recognize that as he or she loses the kind of direct contact with a patient/client that occurs in an in-person, face-to-face office, the psychologist incrementally loses much of the richness of interaction which, as any psychologist knows, comes with traditional face-to-face contact. For this reason, a psychologist should seriously consider conducting the initial evaluation of a client in-person before beginning electronic provision of services, and holding sessions in-person periodically thereafter.  A psychologist should also recognize that without such in-person, face-to-face interaction, patients/clients may misinterpret or feel injured by a psychologist’s statements, tone of voice, or other perceived empathic failures, and the psychologist may fail to observe the signs of this in a timely way.  This may lead to the patient filing a complaint, prematurely terminating the therapy, or both.

In addition, delivery of clinical services by technology-assisted media such as telephone, use of video, and the internet obligate the psychologist to carefully consider and address a myriad of issues in the areas of structuring the relationship, informed consent, confidentiality, determining the basis for professional judgments, boundaries of competence, computer security, avoiding harm, dealing with fees and financial arrangements, and advertising. Specific challenges include, but are not limited to, verifying the identity of the client, determining if a client is a minor, explaining to clients the procedure for contacting the psychologist when he or she is off-line, discussing the possibility of technology failure and alternative modes of communication if that failure occurs, exploring how to cope with potential misunderstandings when visual cues do not exist or are insufficient, identifying appropriately trained professionals who can provide local assistance (including crisis intervention) if needed, informing internet clients of encryption methods used to help ensure the security of communications, informing clients of the potential hazards of unsecured communication on the internet, telling internet clients whether session data are being preserved (and if so, in what manner and for how long), and determining and communicating procedures regarding the release of client information received through the internet with other electronic sources.

The Board’s current position is that the practice of psychology occurs where the patient/client who is receiving the services is physically located at the time of service. In order for a psychologist to provide psychological services to a patient in Massachusetts, that individual must be licensed by the Massachusetts Board of Registration of Psychologists or be exempt under the provisions of M.G.L. c. 112 §.123. If the patient/client is in Massachusetts at the time of service, and files a complaint against the treating psychologist, that complaint will be heard in Massachusetts.  

A Massachusetts psychologist who renders psychological services electronically to a client who is not in Massachusetts is advised to contact the psychology licensing board in the state in which the patient is at time of service, to determine whether or not such practice is permitted in that jurisdiction.

 Licensees are advised to review the following:

M.G.L. ch. 112, s. 118-129b

https://malegislature.gov/Laws/GeneralLaws/Search

APA Ethical Principles of Psychologists and Code of Conduct (Standards 3.10(a), 4.02(c), 5.01(a), and 5.04 specifically address electronic transmissions).

http://www.apa.org/ethics/code/index.aspx

APA/ASPPB/APAIT Joint Task Force Telepsychology Guidelines

(http://www.apa.org/practice/guidelines/telepsychology.aspx)

Social Workers

Massachusetts Board of Registration of Social Workers

Practice Advisory regarding social work services by electronic means

Adopted by the Massachusetts Board of Registration of Social Workers on October 22, 2013.

http://www.mass.gov/ocabr/licensee/dpl-boards/sw/regulations/board-policies/adv-sw-services-electronic-means.html

The Board of Registration of Social Workers (“the Board”) voted today to adopt the following practice advisory about providing social worker services by electronic means.

This practice advisory does not have the force of law or regulation, but is intended to provide social workers and the public with a recommended protocol to follow in situations where social work services are not provided in the traditional face-to-face practice setting.  The Board will look to this practice advisory in considering matters within its scope.

Scope:

This Practice Advisory addresses the provision of social worker services by electronic means of communication (“e-practice”), which includes but is not limited to:  telephone calls, internet video conferencing , texting, and electronic mail.

Practice Guidance:

In response to inquiries from licensees and other interested parties about providing social work services by e-practice, the Board has reviewed and considered appropriate protocols for providing such services.  Social workers must recognize that as he or she moves away from direct contact with clients, the social worker loses the value of interacting with the client which comes with traditional face-to-face practice setting.  While e-practice is not encouraged by the Board, the Board recongnizes that in certain circumstances e-practice can be used as a complement to an existing face-to-face therapeutic relationship OR when warranted by extenuating circumstances.

Licensees are reminded that all of the statutes and regulations that govern traditional Social Work are still applicable when treating a client via e-practice.  The Board, therefore, recommends that licensees conduct the initial evaluation of a client in person before treating a client via e-practice, and conduct subsequent sessions in person periodically thereafter to best service the needs of their clients.

Treating clients via e-practice obligates licensees to carefully consider and address diverse issues such as structuring the relationship, obtaining informed consent, maintaining confidentiality, determining the basis for professional judgments, determining boundaries of competence, maintaining computer security, avoiding harm, dealing with fees and financial arrangements, and advertising.

License:

In order to provide social work services in Massachusetts, you must be licensed by the Board or be exempt under the provisions of M.G.L. c. 112, §134.  In determining whether social work services are being rendered in Massachusetts, the Board considers licensure with the Board necessary when the Patient/Client is located within the Commonwealth.  If a Massachusetts licensee renders social work services via e-practice to an out-of-state client, the Board recommends that the licensee contact the social worker licensing board in the state where the client is located  to determine whether such practice is permitted in that jurisdiction. 

Confidentiality:

Licensees are advised to review M.G.L. c. 112, s. 130-137, 258 CMR s. 22.00 (Confidentiality of Client Communications and Records), and the NASW Code of Ethics (Ethical Standards 1.07(i) and (m) addressing assuring confidentiality of communications with clients).  The NASW Code of Ethics can be found here:  http://www.socialworkers.org/pubs/code/code.asp.

Counselors and Marriage and Family Therapists

Policy on Distance, Online, and Other Electronic-Assisted Counseling

http://www.mass.gov/ocabr/licensee/dpl-boards/mh/regulations/board-policies/policy-on-distance-online-and-other.html

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on November 16, 2007 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.

Policy No. 07-03

Purpose:

The Board acknowledges that therapy and counseling are increasingly being provided at a distance, making use of the internet, telephone and other electronic means of communication. The emergence of new clinical procedures is necessarily accompanied by uncertainty about legal and ethical obligations. The purpose of this policy statement is to offer guidance to Licensees regarding the ethical obligations and standards of conduct in the use of distance, on-line, and other electronic assisted counseling.

Policy:

The Board's policy with regard to all distance or electronic-assisted provision of clinical services is as follows:

1. The services offered by licensees of this Board across a distance by electronic means, fall within the jurisdiction of the Board just as traditional, face-to-face services do. Therefore all Board policies and regulations will apply to these services.

2. Distance delivery of counseling and therapy is considered to occur in two locations: where the client is located and where the clinician is located.

3. Therefore, the provision of counseling and/or therapy to individuals located within Massachusetts at the time services are occurring, are considered to fall under the jurisdiction of the Board, regardless of the location of the provider.

4. Mental health professionals licensed by any jurisdiction other than Massachusetts, and not licensed by any Massachusetts Board or not eligible for an exception to Massachusetts licensure, are considered unlicensed by this Board for practice in Massachusetts.

5. Mental health professionals licensed by other jurisdictions who wish to provide services to clients within Massachusetts, are encouraged to apply for Massachusetts licensure. Some, licensees may find the following helpful:

a. Mental Health Counselors: 262CMR 2.03, (1) Licensure for CCMHC's in good standing with NBCC

b. MFT's: 262 CMR 3.04 Licensure by Reciprocity for MFT's.

6. Board licensees who wish to provide services via electronic means to clients located outside of Massachusetts are urged to ensure that they meet the requirements for practice within the jurisdiction where the client is located.

7. Licensees are encouraged to carefully review the way in which the structure of their relationships with clients will be impacted by distance-therapy or counseling to ensure compliance with Board regulations and standards of practice.

8. The following are some areas of practice that licensees should carefully consider:

a. Informed consent

b. Confidentiality

c. Basis for making clinical judgments

d. Areas of competence

e. Avoiding harm

f. Fees and financial arrangements

g. Advertising

h. Abandonment of clients

i. Handling requests for obtaining clinical records

9. The Board expects licensees to understand and overcome the significant challenges inherent in providing counseling and therapy without face-to-face contact with the client.

10. Some of the challenges that licensees are expected to manage include, but are not limited to:

a. Full disclosure with regard to potential risks to confidentiality, including computer hacking and/or archiving of communications.

b. Full disclosure of the limits to confidentiality in the jurisdictions where the client, and where the clinician are located.

c. Full disclosure of mandated reporting requirements in the jurisdictions where the client, and where the clinician are located.

d. Full disclosure with regard to the potential disadvantages or limitations of electronic-assisted clinical services.

e. Redirection and/or referral of clients for whom electronic services will not be adequate or appropriate.

f. Full disclosure with regard to fees and billing practices.

g. Full disclosure with regard to licensing, credentials and areas of expertise.

h. Screening and local referral for critical and urgent problems.

i. Verification of the identity and age of the client.

j. Obtaining consent to provide services by a guardian for minors or other vulnerable clients.

k. Management of any misunderstanding or compensation for any missing information, resulting from the lack of visual or auditory cues.

l. Managing the problem of incomplete or inaccurate diagnoses that may result from electronic-assisted services.

m. Managing the potential for technology failure

n. Procedures for contacting the clinician when he/she is offline

11. The Board expects that licensees providing any form of distance counseling will comply with all of the guidelines of ethical practice that apply to traditional, face-to-face counseling.

12. The Board expects that licensees will practice distance counseling in a manner that is consistent with any existing guidelines provided by their professional associations.

13. The Board expects that licensees providing any form of distance counseling will ensure that they are properly trained to manage the specific challenges of this form of counseling and will regularly participate in sufficient continuing education activities that maintain and update the required skills.

14. Unlicensed providers of electronic-assisted counseling will be treated by the Board in the same manner as providers of unlicensed counseling in traditional settings.

Authority:

M.G.L. Chapter 13, Section 90; and 262 CMR 8.00 et seq.

Page 1 of 3
This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...
This course was very informative for me as a clinician and for my profession
Roseline Ngoeh
Community Clinician / NPS

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

ZUNILDA CHAUDRY
Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara
LPC-S, LMFT

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist

Awesome

Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock
Therapist

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

TRUDY POST SPRUNK, LMFT-S LPC CPCS RPT-S CPT-S EMD
Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy